Pharmacy network computer system and printer

ABSTRACT

The invention provides a network computer system and novel pharmacy printers and their methods of use wherein the local CS includes a pharmacy printer for printing pharmacy orders including prescriptions, and the pharmacy printer includes a pharmacy printer database storing drug information and association of a drug identifier with information about a corresponding drug, and additional information, and obtains and uses instructions for printing the additional information in association with printing of a prescription label from characters contained in a prescription label print file for the prescription label.

CROSS REFERENCE TO RELATED APPLICATIONS

This application, attorney docket reference PIP174BANFU-US, claimspriority to provisional application 60/759,552, filed Jan. 18, 2006, thecontents of which are incorporated herein by reference.

FIELD OF THE INVENTION

This invention relates generally to computerized systems for printinginformation about medicines sold in pharmacy stores.

BACKGROUND ART

Currently, pharmacy printers print information about a medicine on amedicine label for distribution to the consumer along with thecorresponding medicine. Often, the label is designed to be fixed topackaging for the medicine. The medicine label is generated after theconsumer orders the medicine and prior to when the consumer receives themedicine. Systems for printing a medicine label and related advisoryinformation are described in U.S. Pat. No. 6,304,849 entitled “Methodand system for printing a combination pharmaceutical label and directednewsletter”; U.S. Pat. No. 6,240,394 entitled “Method and apparatus forautomatically generating advisory information for pharmacy patients”;and U.S. Pat. No. 6,067,524 “Method and system for automaticallygenerating advisory information for pharmacy patients along withnormally transmitted data” all of which name Baxter Byerly as aninventor, and the teachings of which are all incorporated herein byreference.

U.S. Pat. No. 5,729,666 describes conventional processes for generating,in a computer associated with a printer, print files containing fontheader data enabling the printer to render fonts, and then the computertransmitting the print file to the printer for printing.

A medicine prescription label may include patient name, doctor name,drug expiration date, the name of the drug, the manufacturer of thedrug, instructions for taking the drug, the quantity in the bottle, thenumber of refills, the date of fill, the day the prescription waswritten, history or medical record number, the prescription number, thename of the pharmacy, the address of the pharmacy, the phone number ofthe pharmacy, cautions or warnings.

Acronyms

NDC is an acronym for National Drug Code.

DCC is an acronym for Drug Classification Code.

CS is used herein as an acronym for “Computer System”.

CHR is an acronym for Catalina Health Resources.

POS is an acronym for Point of Sale.

FDA is an acronym for Food and Drug Administration.

CID is an acronym for Consumer IDentification. CID and PID aresynonymous in this application.

XML is an acronym for Extensible Markup Language.

Definitions

A CID means any identifier that can be used to identify a consumer thatcan be scanned, read, or otherwise entered into a computer.

A “consumer” means a person or family or group of people that use thesame CID when purchasing or filling a medicinal prescription in a store,such as a pharmacy store.

A POS is an area where a consumer engages in transactions with a retailstore, such as a pharmacy store.

NDCs are codes associated with drugs. Preferably, NDCs are the unique11-digit 3-segment number that identifies the labeler/vendor, product,and trade package size of a medication listed under Section 510 of theU.S. Federal Food, Drug, and Cosmetic Act.

DCCs are codes associated with medications based upon the medication'seffects on human beings such that several medications may have the sameDCC.

Individual transaction data includes but is not limited to dataconveying some or all of following information: time of transaction,date of transaction, CID, individual transaction ID, pharmacy ID,product purchased, price of product purchases (list price and/or actualprice paid), payment instrument type, payment instrument identifier.

Pharmacy, in this application, refers to a retail store in whichmedicines are provided to consumers.

Database, in this application, means data organized in some format in acomputer memory that can be read and written by an associated CS. Such aconcept is also referred to as a database management system. Examples ofdatabases include commercial database products such as Microsoft Access,SQL server, and any set of files stored in computer memory that can beaccessed by an associated CS.

Network means communication channels (wired or wireless) and protocolsthat a set of computers can use to exchange and interpret information.Such channels include dial up telephone data connections, privatedigital corporate network, and the Internet. Such protocols include realconnection modem protocols and virtual connection packet protocols likeTCP/IP.

A drug monograph is a written description of a drug or medicineassociated with an NDC. For example, a monograph can include informationsuch as, introduction, summary, pharmacology, pharmaco-kinetics, FDAapproved indications, off-label uses, dosage and administration, adverseeffects, overdose, safety data, contraindications, warnings,precautions, drug interactions, efficacy measures, cost comparison,clinical trials, conclusions, recommendations, references, supplied, andresearch. A drug monogram contains text, which may be stored in a textcomputer file.

A MedGuide is a guideline containing FDA-approved patient informationassociated with a DCC. For example, a MedGuide can include informationsuch as, important information a patient should know about the drug,what the drug is, who should not take the drug or medicine, informationa patient should tell a doctor before starting the drug, how a patientshould take the drug, how a patient should store the drug, what apatient should avoid while taking the drug, the side effects of thedrug, other information about the ailment of which the patient is takingthe drugs for, the ingredients of the drug, and general informationabout the safe and effective use of the drug. A MedGuide contains text,which may be stored as a text computer file.

CHR additional content means drug monograph and MedGuide informationassociated with a medicine.

CHR content means content associated with a patient resulting fromapplying criteria to the patient's prescription, the patient's masterrecord, or the prescription label print file (defined below).

CHR content may include (1) patient specific information such as, thatpatient's CID, (2) information concerning products related to a drugwhich the patient has purchased or for which the patient has received aprescription, or a government warning relating to drugs associated inany way with the patient, (3) information relating to patient health(represented in both text and graphic formats), (4) a news item selectedfor presentation to the patient, (5) incentive offers for printing inthe form of bar coded coupons for discounts off purchase of specifiedproducts, or instant discounts applicable against the price or a productin a subsequent purchase by the consumer, typically for health relatedproducts, and typically products related to a disease associated withthe patient based upon pharmacy product purchase data in the patient'sdata record.

CHR content may in theory also include, although such inclusion may beprohibited by privacy regulations, the patient's name, address,telephone number, and email address, the patient's doctors appointmentsreminders, the patient's doctor's name, address, telephone number, andemail address, the patient's billing information such as patient'sinsurance policy identifier.

A prescription label print file herein means a file transmitted to aprinter for printing a prescription label for prescription.

A prescription label print job herein means a set of commands to beexecuted by a printer to print in response to receipt by the printer ofa prescription label print file, wherein the prescription label printfile does not include CHR content or CHR additional content, but doesinclude a reference to such content, and the prescription label printjob include printing of CHR content and CHR additional contentreferenced by the prescription label print file.

SUMMARY OF THE INVENTION Objects of the Invention

It is an object of this invention to improved the speed and reliabilityof information provided to recipients of medicines in pharmacies.

It is another object of the invention to enable centralized control ofinformation to be included by multiple pharmacy stores in medicinelabels.

Another object of this invention is to reduce the cost and complexity ofsystems for generating targeted medicine labels.

SUMMARY OF THE INVENTION

These and other object are generally provided by a network CS thatincludes a novel printer located in a pharmacy store wherein the novelprinter stores a database of one or both of CHR additional content andCHR content, and the printer implements code to enable the printer toselectively incorporate CHR additional content and CHR content in aprescription label print job based upon codes contained in aprescription label print file received by the printer. These and otherobject are also provided by the network CS that receives prescriptionorder and that determines what CHR content and CHR additional content toinclude in a prescription label print job for a prescription order andgenerates and sends to the novel printer a corresponding prescriptionlabel print file for the prescription order. Code may exist either onthe printer, a central CS, or a local CS that is designed to applycriteria to field values associated with a prescription, such as filedvalues for fields payor, age/dob, gender, new prescription indicator,refill number, pill count, and NDC to determine what if any CHR contentto print in association with the prescription label. The foregoing fieldvalues may be incorporated into a prescription label print file receivedby the printer.

These and other objects are provided by a novel network CS and method ofits use wherein the network CS includes at least:

(1) a central CS;

(2) a plurality of local CSs;

wherein said central CS and said plurality of local CSs form a networkin which said plurality of local CS and said central CS can communicatewith one another via network protocols;

wherein each local CS of said plurality of local CSs is associated withand proximate to one of a corresponding plurality of pharmacy stores,wherein each local CS of said plurality of local CSs includes a CSterminal for inputting information about pharmacy orders and a pharmacyprinter for printing information relating to said pharmacy orders;

wherein a first local CS of said plurality of local CSs includes a firstpharmacy printer located in a first pharmacy store and a first pharmacyPOS located in said first pharmacy store;

wherein said first pharmacy printer includes a first pharmacy printerdatabase storing:

(1) medicine records including in each medicine record a medicineidentifier in association with information about the correspondingmedicine;

wherein said first pharmacy printer is configured to receive and processprint instructions resulting from a pharmacy order containing aspecified prescription for a specified medicine having a specifiedmedicine identifier and a specified consumer identifier for a specifiedconsumer, by:

(1) searching in said first pharmacy printer database for informationabout said specified medicine associated with said specified medicineidentifier;

(2) searching in said first pharmacy printer database for additionalinformation to be conveyed to said specified consumer associated withsaid specified consumer identifier;

(3) printing in association with one another said specifiedprescription, said information about said specified medicine, and saidadditional information to be conveyed to said specified consumer.

Optionally, the printer database also includes, (2) consumer recordsincluding in each consumer record a consumer identifier in associationwith additional information (referred to herein below as “CHR content”)to be conveyed to the consumer associated with said consumer identifier;wherein said first pharmacy printer is configured to (2) search in saidfirst pharmacy printer database for CHR content to be conveyed to saidspecified consumer associated with said specified consumer identifierand print that CHR content for the consumer in association with saidspecified prescription.

The association with CHR content or (referred to herein as “CHRcontent”) to be conveyed to the consumer associated with said consumeridentifier may be by storing the actual CHR content in the consumerrecord.

Alternatively, and preferably, the consumer record includes a CHRidentifier, and the first pharmacy printer also includes a CHR contentor information database containing records having CHR identifiersassociation with CHR content. In this alternative, the first pharmacyprinter includes code to identify, from the CHR identifier in a consumerrecord, the corresponding CHR content or information for printing forthe corresponding pharmacy order.

Preferably, said first local CS includes code instructing said firstlocal CS to transmit to said central CS information about pharmacyorders including associated consumer identifiers and an addressassociated with said first local CS.

Preferably, the central CS (which may include by definition the CHR CS)includes code for determining from (1) criteria it stores and (2)information about pharmacy orders associated with said specifiedconsumer identification, CHR information to associate with saidspecified consumer identification, and said CHR CS includes code fortransmitting an identifier of said CHR information to associate withsaid specified consumer identification to said first local CS.

In the preferred embodiment, the central CS and CHR CS are distinct CSs,for example, having different WAN IP addresses, the central CS storesthe master patient records and format and transmits prescription labelprint file to pharmacy printers in response to receipt of prescriptionorder from the local CSs (ASP model), and the CHR CS stores and managesperiodic or aperiodic distribution to the local CSs of the CHR contentand optionally the CHR additional content (not in response to anyparticular prescription order).

Preferably, said central CS includes code for transmitting to said firstlocal CS medicine records including in each medicine record a medicineidentifier in association with information about the correspondingmedicine.

Preferably, said first local CS includes code for storing in said firstpharmacy printer database (1) medicine records including in eachmedicine record a medicine identifier, such as an NDC, in associationwith CHR additional information about the corresponding medicine, suchas a drug monograph and a MedGuide and (2) CHR content information toassociate with said specified CID that said first local CS receives fromsaid central CS, such as targeted health information or companysponsored information from the company making the prescribed medicine.

Preferably, said medicine records comprise corresponding drug monographdata and MedGuide data.

Said additional information to associate with consumer identificationsmay include at least one of (1) names of alternative brands of amedicine specified in prescriptions contained in the correspondingpharmacy order, (2) information and advertising promoting the medicinespecified in the prescription or the brand or medicine actuallydistributed by the pharmacy in response to the prescription (3) anincentive offer for a discount or credit on purchase of a product otherthan said medicine, (4) health related information broadly targetedbased upon available data in the file received by the printer and notspecifically promoting any particular product. In addition, theadditional information may include sufficient information to imply apatient's disease state, such as a combination of medicines, age,gender, and other information often associated with a specific diseaseor class of diseases. From that information, an informational messagerelating to the implied disease state may be triggered and printed forthe patient.

In one alternative, said central CS includes code for periodicallytransmitting additional information that it has associated with saidspecified consumer identification to said first local CS.

In one alternative, said central CS includes code for automaticallytransmitting additional information that it has associated with saidspecified consumer identification to said first local CS in response totransmission from said local CS to said central CS of said specifiedconsumer identification. That enables said additional information to beprinted by said first printer concurrently or sequentially with printingby said first pharmacy printer of said specified prescription andinformation about said specified medicine.

Preferably, the elements of the local CS including the CS terminal andthe pharmacy printer in each pharmacy store are inside a local areanetwork (LAN).

Preferably, the central CS is networked to each one of the local CSsover a wide area network, such as a private WAN, the Internet, or a setof dial up Plain Old Telephones (POTs) lines. Preferably, the datatransmission speed in said LAN is greater than the data transmissionspeed in said WAN.

The inventors recognize that, while drug monographs and MedGuides can bestored as relatively small text files, the graphical information for CHRcontent that the inventors want to associate with CIDs may require arelatively large amount of memory for storage, often occupying more thanone megabyte and typically occupying on the order of 10 megabytes. Theinventors envision the size of data storing this information to increasewith time, for example, possibly to 100 megabytes in the next few years.The inventors envision storing much or all of this CHR content datalocally in the pharmacy printer, thereby avoiding redundant datatransfer to the pharmacy printer of large volumes of CHR content.

The printer may also store local rules that the printer implements inaddition to the rules instructing it what to print based uponidentifications of medicines and CIDs. The additional local rules mayinstruct the printer with (1) additional content local rules, to printadditional text or graphics, upon receipt of instructions to printspecified CHR content and/or additional CHR content and the other printfile information, and with (2) layout local rules, to lay out all of thematerial for printing defined by the print file information and thespecified CHR content and/or additional CHR content, depending upon allof the material for printing, the type of the local printer, and localprinter's print specifications, such as paper width and margins.Preferably, one or both of the central CS and the CHR CS store a masterset of rules based upon printer type, material for printing, and printspecifications, and includes code specifying that the central CS or CHRCS distribute corresponding rules to printers having the printer type,material for printing, or print specifications stored by the central orCHR CS, or both.

The first pharmacy printer may receive in response to a single pharmacyorder print instructions from a first local CS controller CPU in thefirst local CS and also from the central CS. For example, the firstlocal CS controller CPU may process the pharmacy order payment aspectsto specify costs of the transaction, to itemize product items includedin the pharmacy order, to request and receive payment or credit from athird party insurer or credit card company. The central CS may receiveat least the prescription information in the pharmacy order and respondduring the transaction involving a consumer in the first pharmacy bytransmitting CHR additional content identifiers in association with theprescription and an order ID, or in association with the CID, back tothe first pharmacy printer. The central CS may associate the customermaster record with the prescription order and transmit back to the localCS a prescription record supplemented by information from the customermaster record, and that transmission may include or contain theprescription label print file for the prescription. The first pharmacyprinter may include code to prioritize print instructions received fromboth the first local CS controller CPU and the central CS regarding asingle pharmacy order, and print transaction information, prescriptionlabel, and all other related information accordingly.

The pharmacy printer may be configured to print partially on an adhesivebacked portion of printer paper and partially on a non-adhesive backedportion of paper. For example, the pharmacy printer may be designed toformat printing so that prescription information is printed on anadhesive backed portion so that it can be readily attached to aprescription drug container, and the pharmacy printer may be designed toformat printing so that CHR additional content (drug monograph,MedGuide), and CHR content is printed on a portion of material having aperforation separating it from the prescription information so that itcan be separated at a perforation line from the prescription labelportion of the pharmacy label.

The central CS may store transaction data it receives from each one ofthe plurality of local CSs. The central CS may run criteria against alltransaction data associated with a CID, regardless at which pharmacystores the transaction data originated.

Preferably, the CHR CS maintains an up to date list of drug monographand MedGuide data for a large number of drugs, and updates each of thepharmacy printers with that information via transmissions over thenetwork. Alternatively, or in addition, the central CS, may also CSmaintain an up to date list of drug monograph and MedGuide data.

In some embodiments, the local CSs only transmit, outside of its LAN,de-identified pharmacy order information and encrypted versions of theassociated CIDs to protect privacy. De-identified, means thatinformation that could be used to identify the corresponding person, isremoved. That information includes for example, name, residence address,telephone number, email address, and demographic information particularto a small group of individuals. Either the CHR CS or the central CS mayrun criteria on the de-identified information and transmit back to thelocal CS encrypted CIDs in association with identifiers for CHRinformation, and the pharmacy printer includes code to associate thosefrom the encrypted CID, the non-encrypted CID. Preferably, the CHR CSruns the foregoing criteria.

The local CS may be implemented in various network architectures. Forexample, the local CS may be a POS CS that includes a store controllerCPU having a LAN address, a pharmacy printer including a CPU and memoryand also having a LAN address, and a router logically separating the LANfrom the WAN. Alternatively, the store controller CPU may act as arouter logically separating the LAN from the WAN. Alternatively, thepharmacy printer may include a CPU and memory but have no separate LANaddress, and instead it may communicate with the store controller CPUvia always on connections as opposed to packet switched virtualconnections.

Examples of criteria that can be used to determine CHR content toassociate with a CID or encrypted CID include: NDC, age; gender; numberof allowed refills; refill number; payor; whether the prescription is anew prescription; implied patient disease state; no criteria(associating certain CHR content with every CID, such as publicannouncements); sequential (distribute certain additional CHR content toevery second, third, fourth, etc. CID identifier from a POS, as theyappear at a POS, or as they appear in a local CS having multiple POSs);random (randomly distribute certain CHR content to CIDs); to specifiedfrequent shoppers based upon shopping or specific product purchasefrequency or existence of a prior purchase, specified demographic data,specified frequency of purchases, specified frequency of visits to alocation, specified frequency that a consumer exercises incentives,specified purchase history of the consumer, specified particularcircumstances in the consumer's life, specified indicated tastes of theconsumer, other characteristics of the consumer associated data thatindicates a consumer possesses certain traits, specified purchase ofspecified items in specified time periods, specified transaction dollarvolume, specified transaction frequency, specified associated pharmacy,region, address, retail chain, and/or postal code.

Preferably, a patient master record table exists, either stored locallyin local CS database 30A or centrally in central CS database 20A or CHRCS database 50A, or stored at any combinations of the foregoing.Preferably, the patient master record table includes for each recordfields storing for example: CID or encrypted CID, date of birth or age,gender, insurance plan ID, payor, and insurance company name. The patentmaster record may be used to associate date of birth or age, gender,insurance plan ID, payor, and insurance company name with a patient'sprescription record, and to determine CHR non-CID additional contentmentioned below.

Example of CHR content triggered by those criteria include (1)additional information provided by the company producing that medicineabout a prescribed medicine, and information about a disease which canbe associated with the patient based upon data in the customer masterrecord table, or, associated with the patient by the printer based uponthe data it receives in the prescription label print file.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 is a schematic of a novel network CS;

FIG. 2 is a schematic of a data structure of central CS database 20A ofFIG. 1;

FIG. 3 is a schematic of a data structure of local CS database 30A ofFIG. 1;

FIG. 4 is a schematic of a data structure of pharmacy store printerdatabase 40A of FIG. 1;

FIG. 5 is a schematic of a data structure of CHR CS database 50A of FIG.1;

FIG. 6 shows data elements of a prescription record 600 received fromterminal 30C of local CS 30;

FIG. 7 shows data elements that may be in a data transmission of aprescription label print file to pharmacy printer 40 in response to apharmacy order received from terminal 30C of local CS 30;

FIG. 8 shows data elements in a drug monograph record 210;

FIG. 9 shows data elements in MedGuide table 220 of FIG. 2;

FIG. 10 shows data elements in CHR content table 240 of FIG. 2;

FIG. 11 is a schematic showing inter relationships between elements ofthe drug monograph, MedGuide, and CHR content records and process flowfor printing prescription labels with drug monograph, MedGuide, and CHRinformation;

FIG. 12 is a flow chart showing at a high level novel process steps forusing the network CS;

FIG. 13 is the first page of a drug monograph for the drug brand nameZoloft; and

FIG. 14 is the first page of a MedGuide for the drug corresponding tobrand name Zoloft.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1 shows novel network CS 1 including:

WAN network 10;

associated with a pharmacy central office: central CS 20; and a centralCS database 20A;

associated with pharmacy store A,30: local CS 30; local CS database 30A;local CS terminal 30C; pharmacy printer 40; pharmacy printer database40A; pharmacy store switch 60;

pharmacy stores B, C, . . . indicating equivalent network computerstructure to that illustrated for pharmacy store A;

CHR CS 50 and CHR CS database 50A; and line 70, 71, 72.

Network 10 may be the Internet, a private packet switching network, or atelephone dial up communication system. Lines 70 represent local areanetwork (LAN) connections between network addressable computerizedcomponents. Lines 71 between a CS and a database represent that theconnected CS controls read and write access to the connected database.Lines 72 between computer components and WAN 10 represent a relativelyslow speed network connection to WAN 10.

Each one of central CS 20, local CS 30, and CHR CS 50 includes a digitalcentral processing unit, human user input and output devices, andassociated high speed memory. Each one of these CSs stores networkprotocols and code for converting and transmitting data in those networkprotocols, such as TCP/IP.

One or both of local CS 30 and central CS 20 are configured to receiveand store in their respective databases pharmacy transaction data fortransactions in pharmacy store A.

Pharmacy store switch 60 in a preferred embodiment is a router designedto route packet switched signals from computers inside a LAN, such as aLAN including local CS 30 and printer 40, to WAN IP addresses, such asan address for central CS 20, and to route packets from the WAN to theassociated LAN computers specified by IP address information in incomingpackets.

In one less preferred alternative embodiment, store switch 60 isreplaced by a dial up modem telephone connection.

In another less preferred embodiment, no pharmacy store switch 60 existsand network addressing services to both printer 40 and local CS 30 areprovided local CS 30. In this alternative, all signals addressed toprinter 40 first pass through local CS 30.

Printer 40 includes conventional structure or code for printing basedupon print instructions, and also conventional structure or code forreceiving and interpreting information in at least one networkprotocols, such as TCP/IP.

In preferred embodiments, printer 40 also includes in printer database40A drug monograph, MedGuide, and CHR additional content, along with alist of pointers to data elements therein. In these preferredembodiments, printer 40 includes structure or code for acting oninstructions including pointers and/or names data, for including in apharmacy label printout, monograph, MedGuide, and CHR additional contentidentified by the pointers and names.

CHR CS 50 and its database 50A store addresses of CSs to update withdrug monograph, MedGuide, and CHR content, addresses and/or names foreach drug and content's data record, criteria for selecting drugmonograph, MedGuide, and CHR content, code to distribute updatedcontent, address, and name information to CSs.

Central CS 20 and database 20A optionally includes therein all data andfunction ascribe to GM CS 50.

Central CS 20 runs code implementing criteria on pharmacy transactiondata associated with CIDs to determine specified content to associatewith the CIDs. Central CS 20 distributes identifiers of specifiedcontent associated with an associated CID, in association with that CID,back to the pharmacy printer or printers from which the transaction dataoriginated. The transmission may be to an address for each such printer.Alternatively the transmission may be to an address for a local CScontaining that printer in which case the local CS is programmed toforward the transmission or at least the identifiers and associated CIDsto the pharmacy printer.

For example, criteria may depend upon patient age, gender, prescriptionhistory, or product purchase history. Specific content associated viacriteria with a CID may include informational messages, incentive offersto purchase or sample a product, and instant discounts.

Tables herein means both tables as defined for relational databasestructures and other data associations such as those enabled by XML andXML tagging.

FIG. 2 shows central CS database 20A of FIG. 1 as including patientmaster records table 205, drug monograph table 210, MedGuide table 220,NDC/DCC association table 235, link 230 from NDC field of drug monographtable 230 to NDC/DCC association table 235, link 231 from DCC field ofNDC/DCC table 235 to DCC field of MedGuide table 220, CHR content table240, pharmacy store addresses table 250, transaction logs and accountingdata structure 260, targeting criteria data structure 270, and code 280.As mentioned above, central CS database 20A may also include the CHRcontent table 240 shown in FIG. 5. Links 230, 231 denote that datafields in records for drug monographs and MedGuide information storecorresponding data to field in the NDC/DCC table. Links 230, 231 enablecode to determine which drug monographs correspond to MedGuides for thatdrug.

Central CS 20 uses pharmacy store address table 250 to store networkaddresses data for local CSs and pharmacy store printers. A CHR CS maystore an analogous table. Central CS 20 uses data structure 260 to storetransaction logs and accounting logs based upon data received from theplurality of local CSs. In some cases, transaction logs data containencrypted CIDs and de-identified transaction data.

Preferably, central CS 20 received complete data transaction records andany CHR CS received de-identified records.

Code 280 includes for example operating system code, and applicationscode, including the code to transmit content, identifiers in associationwith CIDs, to determine network addresses for transmissions, and todetermine associations of content identifiers with CIDs.

FIG. 3 shows local CS database 30A preferably including storetransaction logs and accounting data structure 310 for storingtransaction logs and accounting data for the corresponding pharmacystore, network address and data table 320 for storing for example LANand WAN network addresses, and code 330.

Code 330 could include for example aspects of conventional local POS CSprocessing for accounting for inventory and transactions.

FIG. 4 shows pharmacy store printer database 40A including drugmonograph table 410, MedGuide table 420, CHR/CID content table 430,CID/CHR identifier table 440, CHR/Non CID content table 430A, identifiertable 440 code 450, NDC/CDD table 460, and logical association line 470.Tables 410 and 420 are segmented to illustrate the NDC or DCCidentifiers for corresponding data describing a specified drug or classof drugs. CHR content table 430 is likewise segmented to show that itcontains a CHR identifier field. Table 440 is likewise segmented to showthat it contains both CID and CHR identifier fields. The lines 460, 470define fields containing the information. Table 460 indicate that drugmonograph and MedGuide information for the same medicine can be matched,and that CHR content may be associated with a CID via the matching ofCHR identifiers. The existence of the NDC field, the MedGuide field, andthe CID field enable the printer to receive drug name data and CID dataand to determine from that data drug monograph and MedGuide informationto print, and to determine CHR content to print, in association with aprescription label for a prescription for a patient having that CID.

CHR/non CID additional content table 430A includes field for NDC,whether prescription is new, number of refills remaining, number ofrefills used, payor, pill count or quantity, gender, age and or date ofbirth, and associated informational content. CHR/non CID additionalcontent table 430A does not include a CID field. Printer 40 uses thisdata to determine from data in a prescription label print file whetherto include in the prescription label print job associated informationalcontent. It does so by implementing code matching values and ranges ofthese fields to records in table 430A. For example, printer 40 may runcode determining whether a prescription label print file table 430A isfor a male over age 50 having an insurance payor and, if so, printing,along with the patient's prescription label, information about Viagra,which is a male oriented drug suitable for older men, and if not, notprinting out the information about Viagra. The matching is not dependentupon CID.

The code and determination whether to print based upon the fieldswhether prescription is new, number of refills remaining, number ofrefills used, payor, pill count or quantity, gender, age and or date ofbirth may occur at the central CS or the CHR CS, be associated with aCID, and then be transmitted as a CHR/CID content record to the pharmacyprinter database CHR/CID content table 430, to await the pharmacyprinter's identification of that CID in a prescription label print fileor when the patient's CID is identified in a transaction in thepharmacy. Thus, the non-CID targeting determinations for CHR content mayeither occur remote from the local CS at any time or locally in thelocal CS and preferably in the pharmacy printer using the pharmacyprinter database in response to and as part of processing of receipt ofa prescription label print file into a prescription label print job forprinting by the pharmacy printer.

FIG. 5 shows database 50A of optional additional CHR CS as includingsubstantially the same data structures as central CS database 20A, andalso including update status table 510 to indicate the status ofmonograph, MedGuide, and CHR content of each one of the local CSs and/orpharmacy printers. Central CS 20 may use the update information todetermine when to send new data sets of information to the various localCS and pharmacy printer databases.

FIG. 6 shows data elements of a prescription record 600 received fromterminal 30C of local CS 30 including fields for name of drug, patientname, doctor ID, date of prescription, quantity, number of refills. Inthis regard, the terminal may be one at which a clerk manually keys inthe prescription information, or it may be an automated system toreceive and process prescriptions transmitted remotely from outside thepharmacy store to the pharmacy store's local CS, such as via web access,email, or automated telephone service. Either the local CS or thecentral CS may associate with that information a CID, associate with ade-identified subset of that information an encrypted CID, and determinefrom the CID or encrypted CID, additional information relating to theprescription and the customer as noted in the prescription record 700 inFIG. 7. The local computer system may transmit in de-identified form theprescription information and/or product purchase transactions, to theCHR CS.

FIG. 7 shows a data record for a prescription of the type to betransmitted (either from central CS 20 or local CS 30) to pharmacyprinter 40 in response to a pharmacy order received from terminal 30C.The field or tag names may include name of drug 701 field; patient name705 field; doctor name 710 field; drug expiration date 715 field;manufacturer of drug 720 field; instructions for taking drug 725 field;quantity in the package 730 field; number of refills 735 field; date offill 740 field; date prescription was written 745 field; history/medicalrecord number field 750; prescription number field 755; name of pharmacyfield 760; address of pharmacy 765 field; phone number of pharmacy 770field; cautions or warnings 775 field; and CID 780 field; Age/DOB 781field; gender 782 field; whether a new prescription 783; refill number784 field; pill count 785 field; payor name 786 field; and NDC 787field.

Name of drug 700 field stores the name of the drug for which theprescription was written.

A complete list of the currently contemplated fields in the data recordfor a prescription of the type to be transmitted) to pharmacy printer 40include, in XML tagged data format: message version number; state codefor store location; geographic region; division ID to aid in triggeringdivision specific programs; store ID to aid in triggering store specificprograms; national council for prescription provider ID; English orSpanish language preference; pharmacy system's unique patientidentifier; customer name; name mask flag field indicating printing“Valued Customer” instead of patient name; date of birth; gender; optout flag indicating patient does not want information based uponpatient's record; transaction sequence number generated by local CS forQ/A purposes; script status indicating whether prescription is a newunfilled prescription or a refill; NDC; medication name; prescriptionnumber printed on newsletter; dispensed quantity of medication (pillcount); daily supply quantity; number of days supply; original filldate; expiration of prescription date; prescription refills remaining;alpha numeric associated with a drug monograph; patient directions;doctor's ID; pharmacists directions; boolean indicating whether printingof prescription and newsletter are simplex or integrated; booleanindicating whether to print HIPAA notice; payor (third party payor nameor “CASH” if paid by customer); payor code (third party payor code or“CASH” if paid by customer); payor's processor control number; bankidentification number; legal relationship between agent and principalfor the prescription; insurance policy group ID; and insurance policyplan ID. Based upon any of the foregoing data fields having datapossibly transmitted to the printer, the following data fields andcombination of fields are contemplated with boolean combinations ofrules for triggering to provide different information to differentpatients:

ndc ndc/age/gender ndc/refill ndc/new ndc/PillCount ndc/refill#ndc/refills remaining age/gender payor payor/ndc payor/age/genderpayor/ndc/age/gender payor/ndc/refill payor/ndc/new patient ID or CIDNdc/patient Ndc/new/patient Ndc/refill/patient Ndc/refill#/patientNdc/age/gender/refill/new Ndc/bin no Refill/new /patient ID

In one preferred embodiment, the printer receives the prescription labelprint file as an XML data stream, and data for the foregoing currentlycontemplated fields exists and the beginning of the data stream betweenXML tags indicating to in the PCL printer language to ignore the taggedcontents, such as between “1Bh&foX” and “27d&flX” tags.

An example of a sample prescription label and CHR content file layout isas follows.

Sample Label Stream Layout Printer PCL*[esc]E[esc]&l2S[esc]&l1H[esc]&l1o CHR tagged info [esc]&f0X[All CHRnon-print data elements here][esc]&f1X Pharmacy back side data[monograph] CHR back side marker [esc]&f0X[esc]&f1X Pharmacy front sidedata1 [label information] CHR front side marker [esc]&f0X[esc]&f1XPrinter reset [esc]E

An example of an XML string passing CHR information is as follows:

esc&f0X <newsletter> <BinNumber>12</BinNumber><ControlNumber>12313</ControlNumber> <DailySupply>2</DailySupply><DaysSupply>30</DaysSupply> <DateOfBirth>02/01/1952</DateOfBirth><DispQty>100</DispQty> <DrDEA>12323</DrDEA> <Gender>M</Gender><HIPAA>Y</HIPAA> <Language>E</Language> <MaskName>N</MaskName><MedicationName>DuraVent D/A</MedicationName> <NCPDP>123</NCPDP><NDC>12345678901</NDC> <OptOut>N</OptOut> <PatientID>123456</PatientID><PatientName>Joe Public</PatientName> <Payor>CASH</Payor><RefillsRemaining>2</RefillsRemaining> <ScriptStatus>N<ScriptStatus></newsletter> esc&f1X Note: The above information is intended as anexample and not all fields are included.

Patient name 705 field stores the name of the patient for which theprescription was written. Optionally, this data field may be added torecord 700 in printer 40 in response to receipt of a CID or encryptedCID.

Doctor name 710 field stores the name of the doctor who wrote theprescription for the patient.

Drug expiration date 715 field stores the date in which the drugs willexpire.

Manufacturer of drug 720 field stores the name of the manufacturer ofthe drug.

Instructions for taking drug 725 field stores instructions for takingthe drug. Such instructions can include: take only at night, take 3pills a day, take with a full glass of water, or the like.

Quantity in the package 730 field stores how much of the drug was giventhe to the patient. For example, this field could store that 32 pillswere given to the patient, or 12 oz., etc.

Number of refills 735 field includes how many times the patient mayrefill the prescription without needing a new prescription from thedoctor. For example, this field could store the number 6, indicatingthat the prescription may be refilled 6 times.

Date of fill 740 field stores the date in which the prescription wasfilled.

Date prescription was written 745 field stores the date that theprescription was written.

History/medical record number 750 field stores a medical number uniqueto the patient.

Prescription number 755 field stores a unique number designated by thepharmacy that filled the prescription.

Name of pharmacy 760 field stores the name of the pharmacy which filledthe prescription.

Address of pharmacy 765 field stores the address of the pharmacy whichfilled the prescription. Such address can include a website address or astreet address, including street, city, state, and zip code.

Phone number of pharmacy 770 field stores the phone number of thepharmacy.

Cautions/warnings 775 field stores any cautions or warnings issued bythe government, pharmacy, or doctor in taking the drug. For example, thelabel could read: Caution: Federal law prohibits transfer of this drugto any other person than patient for whom prescribed.

CID 780 field stores a CID. Optionally, the field may be added byprinter 40 in response to receipt of and decryption of an encrypted CID.

Age/DOB field 781 stores age in year or date of birth of the patient.

Gender field 782 store gender, either male or female, or status unknown.

New prescription field 783 store a boolean value indicating whether theprescription is for an unfilled new or a refill request.

Refill number field 784 indicates the number of fills the patient hasobtained on the prescription.

Pill count field 785 indicated the number of pills or quantity ofnon-pill medicine specified in the prescription.

Payor name field 786 indicated the name of the health insurance companypayor if one exists, or “cash” if no the customer does not have or use ahealth insurance policy.

NDC field 787 stores the NDC number for the medicine provided.

FIG. 8 shows a representation of a monograph record in which monographrecord preferably includes name of drug field 800; introduction/summary805; pharmacology/pharmacokinetics field 810; FDA approved indicationsfield 815; off label uses field 820; dosage and administration field825; adverse effects field 830; overdose field 835; safety data field840; contraindications field 845; warnings field 850; precautions field855; drug interactions field 860; efficacy measures field 865; costcomparison field 870; clinical trials field 875; conclusions field 880;recommendations field 885; references field 890; research field 895; andNDC field 896.

Name of drug 800 field stores the name of the drug.

Introduction/summary 805 field stores a summary of the informationprovided in the monograph.

Pharmacology/pharmacokinetics 810 field stores the composition of thedrug, its uses, effects, the characteristics or properties of the drugthat make it medically effective, the process by which the drug isabsorbed, distributed, metabolized, and eliminated by the body.

FDA approved indications 815 field stores symptoms or particularcircumstances that indicates the advisability or necessity of a specificmedical treatment or procedure.

Off label uses 820 field stores uses relating to the drug to treat acondition which has not been approved by the FDA.

Dosage and administration 825 field stores the amount of the drug thatshould be taken and when it should be taken. This field may storedifferent dosage amounts depending on an individuals situation, such asage, or what they are taking the medicine for.

Adverse effects 830 field stores the adverse effects of the drug. Forexample, adverse effects can include one or more of: headache,nervousness, insomnia, drowsiness, fatigue or asthenia, anxiety, tremor,dizziness, lightheadedness, nausea, diarrhea, and excessive sweating.

Overdose 835 field stores information about how much of the drug isconsidered overdose, if and how a person has died from overdose,symptoms of overdose and treatment.

Safety data 840 field stores safety data on the drug, such as dataregarding safety in humans, in animals, and in vitro studies.

Contraindications 845 field stores factors that render theadministration of the drug inadvisable.

Warnings 850 field stores information such as allergic reactions, whoshould not take the drug, what may happen to people who take the drugthat should not be, and what may happen to a person if they overdose.

Precautions 855 field stores information with advice of what to do inadvance to protect against possible danger, failure, or injury relatedto the drug.

Drug interactions 860 field stores information about reactions withother drugs or food interaction with the prescribed drug.

Efficacy measures 865 field stores the ability of the drug to control orcure an illness.

Cost comparison 870 field stores a table which compares similar drugsand dosages and their associated costs.

Clinical trials 875 field stores data on the clinical trials, such asthe method, the criteria, results, conclusions, and critiques.

Conclusions 880 field stores the conclusions of the monograph.

Recommendations 885 field stores how the drug will be available, such asan open access basis or whether the drug should be made available.

References 890 field stores a list of references cited to in themonograph.

Research 895 field stores the research data that was analyzed to arriveat the present monograph.

NDC field 896 stores the NDC for the named drug.

FIG. 9 is a representation of one alternative for a MedGuide recordwhich may include name of drug 900 field, important information aboutthe drug field 905; who should not take the drug field 910; informationa patient should tell a doctor before starting the drug field 915; how apatient should take the drug field 920; how a patient should store thedrug field 925; what a patient should avoid while taking the drug field930; the side effects of the drug field 935; other information about theailment for which the patient is taking the drugs for field 990;ingredients of the drug field 995; general information about the safeand effective use of the drug field 950; and DCC for the drug field 951.

Name of drug 900 field stores the name of a drug.

Important information about the drug 905 field stores a summary of whatthe drug is used to treat, severe side affects, and other importantinformation.

Who should not take the drug 910 field stores information regarding whoshould not take the drug; such as, a person allergic to an ingredient inthe drug should not take the drug.

Information a patient should tell a doctor before starting the drug 915field stores information regarding what a doctor should know beforeprescribing the drug. Such information can include, whether the patientis pregnant, medical history, other drugs the patient is taking,allergies, and the like.

How a patient should take the drug 920 field stores information on howthe drug should be taken. For example, the field can store theinformation that the drug should be taken in tablet form orally every 4hours.

How a patient should store the drug 925 field stores information aboutstoring the drug. This field can contain information such as, store atroom temperature in a closed container, away from heat, moisture, directlight, or keep away from children.

What a patient should avoid while taking the drug 930 field storesinformation about what a patient should avoid while taking the drug,such as, alcohol or other medications.

The side effects of the drug 935 field stores information on sideeffects of the drug; such as, drowsiness, headaches, nausea, dizziness,etc.

Other information about the ailment of which the patient is taking thedrugs for 940 field stores other information about the ailment such aswhat else is used to treat it, the history of the ailment, andcharacteristics of patients who have the ailment.

Ingredients of the drug 945 field stores the ingredients of the drug.

General information about the safe and effective use of the drug 950field stores general information about the safe and effective use of thedrug.

Alternatively, all information for each MedGuide may be stored in asingle text or image field in association with a DCC for the named drug.

FIG. 10 shows a representation of a CHR content record which may includefor example a CID 1000 field, a greeting 1005 field, a doctor'sappointment reminder 1010 field, billing information 1015 field,promotion material 1020 field, information concerning a related product1025 field, discount 1030 field, coupon 1035 field, government warning1040 field, and news item 1045 field.

CID 1000 field stores a CID. Optionally, this field may be generated inprinter 40 upon receipt of an encrypted CID.

Greeting 1005 field stores a greeting for the consumer.

Doctor's appointment reminder 1010 field stores a reminder for aconsumers doctor's appointment. This field may not be present inimplementations employing encrypted CIDs and de-identified information.

Billing information 1015 field stores information regarding billing,such as who was billed, how much the bill was, who paid for the bill,and the like.

Promotion material 1020 field stores information promotion drugsconsumer is on, related drugs, new drugs, etc.

Information concerning a related product 1025 field stores informationconcerning a related product.

Discount 1030 field stores discounts for drugs consumer is taking,related drugs, new drugs, etc.

Coupon 1035 field stores coupons for drugs consumer is taking, relateddrugs, new drugs, etc.

Government warning 1040 field stores warnings issued by the governmentwith respect to the drug or ailment.

News item 1045 field stores news information about the drug, a relateddrug, or any medical news.

FIG. 11 shows exemplary relationships between table or correspondingdata elements in the various data record types including prescriptionrecord 700, drug monograph table 210, MedGuide record NDC/DCC table 235,CHR/CID additional content 240, and CHR non-CID additional content table430A leading to printing.

FIG. 11 shows prescription record table 700 logically linked to drugmonograph table 210 via NDC code. FIG. 11 shows Drug Monograph table 210logically linked to MedGuide record 220 via correspondence of NDC to DCCin NDC/DCC lookup table 235. FIG. 11 shows identification ofpre-existing stored CHR/CID additional content record 240 for CID inprescription record 700 via identification in prescription record 700 ofa corresponding CID.

FIG. 11 shows CHR non-CID additional content table or filter 430A andcorresponding fields in prescription drug record 700 for new/refill,refills remaining, pill count, gender, and age/DOB. Printer codedetermines which if any records in table 430A have values matching thecorresponding field values in prescription record 700, as indicated byoperator 1110. FIG. 11 schematically shows data flows 1120, 1130, 1140,1145 of data for CHR/CID content, CHR non-CID content, CHR additionalcontent (drug monograph and MedGuide), and prescription label contentfor formatting 1150 as a prescription label print job.

FIG. 12 shows method 1200 including in sequence, entering a pharmacyorder in step 1210, transmitting prescription information to a pharmacyprinter in step 1220, in the pharmacy printer, identifying drug and CHRcontent for printing in association with the prescription in step 1230,and then formatting and printing a prescription label and related drugand CHR content information. Either prior to step 1220, additionalinformation relating to the prescription may be added to theprescription data, including information stored in the local CS database30A, the central CS database 20A, or the printer database 30A, by thecorresponding CPU. This information may include additional informationabout patient or the doctor, such as contact information or paymentinformation.

1. A network CS, comprising: a pharmacy printer located in a pharmacystore wherein said pharmacy printer stores therein a database includingat least one of drug monograph and MedGuide content; wherein saidpharmacy printer is configured to parse, from a prescription label printfile for a prescription, data identifying a specified drug monograph anda specified MedGuide stored by said printer in said database, whereinsaid pharmacy printer is configured to retrieve said specified drugmonograph and said specified MedGuide from said database; wherein saidpharmacy printer is configured to generate a prescription label printjob including prescription label information specified by saidprescription label printer file, said specified drug monograph, and saidspecified MedGuide.
 2. A network CS, comprising: a pharmacy printerlocated in a pharmacy store wherein said pharmacy printer stores thereina database including CHR content; wherein said database comprises aCHR/CID content table; wherein said pharmacy printer is furtherconfigured to parse out of a prescription label printer file for aprescription a CID associated with said prescription; wherein saidpharmacy printer is further configured retrieve from said CHR/CIDcontent table, at least one CHR/CID content record associated with saidCID associated with said prescription; wherein said pharmacy printer isconfigured to generate a prescription label print job including aprescription label information specified by said prescription labelprinter file, and said at least one CHR/CID content record.
 3. Thenetwork CS of claim 2 wherein at least one CHR/CID content recordincludes an image object.
 4. The network CS of claim 3 wherein saidimage object occupies in said printer at least one megabyte of memory.5. The network CS of claim 2 wherein said database further comprises: aCHR/non-CID content table; a CHR/non-CID criteria table storing recordsof values or ranges of values for at least one of new/refill, refillsremaining, pill count, gender, age, and date of birth; and said pharmacyprinter is further configured to determine additional CHR content toinclude in said prescription label print job based upon correspondenceof values in said a CHR/non-CID criteria table and said CHR/non-CIDcontent table.
 6. The network CS of claim 2 further comprising a centralCS remote from said local CS, said central CS storing a master patientrecords.
 7. The network CS of claim 3 further comprising a CHR computerremote from said local CS and said central CS, said CHS CS storing CHRcontent and CHR additional content, and structured to update saiddatabase in said pharmacy printer with updated CHR content, CHRadditional content, and CHR/non-CID criteria.
 8. A method for using anetwork CS, comprising: storing CHR content in a database in a pharmacyprinter located in a pharmacy store; wherein said database comprises aCHR/CID content table; parsing, in said pharmacy printer, out of aprescription label printer file for a prescription, a CID associatedwith said prescription; retrieving, in said pharmacy printer, from saidCHR/CID content table, at least one CHR/CID content record associatedwith said CID associated with said prescription; generating, in saidpharmacy printer, a prescription label print job including aprescription label information specified by said prescription labelprinter file and said at least one CHR/CID content record.
 9. The methodof claim 8 wherein at least one CHR/CID content record includes an imageobject.
 10. The method claim 9 wherein said image object occupies insaid printer at least one megabyte of memory.
 11. The method of claim 8wherein said database further comprises: a CHR/non-CID content table; aCHR/non-CID criteria table storing records of values or ranges of valuesfor at least one of new/refill, refills remaining, pill count, gender,age, and date of birth; and said pharmacy printer is further configuredto determine CHR content to include in said prescription label print jobbased upon correspondence of values in said a CHR/non-CID criteria tableand said CHR/non-CID content table.
 12. The method of claim 8 furthercomprising storing a master patient records on a central CS remote fromsaid local CS.
 13. The network CS of claim 9 further comprising: storingon a CHR computer remote from said local CS and said central CS, CHRcontent and CHR additional content, and updating, from said CHRcomputer, said database in said pharmacy printer with updated CHRcontent, CHR additional content, and CHR/non-CID criteria.
 14. A methodof using network CS for printing prescription labels and informationcomprising: locating a pharmacy printer in a pharmacy store; storing insaid pharmacy printer a database including drug monographs inassociation with NDCs and MedGuides in association with DCCs;configuring said pharmacy printer to parse out of a prescription labelprint file data identifying a specified drug monograph and a specifiedMedGuide stored by said printer in said database; configuring saidpharmacy printer to retrieve said specified drug monograph and saidspecified MedGuide from said database, generate a prescription labelprint job including a prescription label information specified by saidprescription label printer file, said specified drug monograph, and saidspecified MedGuide.
 15. The method of claim 14 wherein: said databasefurther comprises CHR non-CID content table including criteria forvalues of at least one of new/refill, refills remaining, pill count,gender, and at least one of age and date of birth; and furtherconfiguring said pharmacy printer to determine CHR content to include insaid prescription label print job based upon correspondence of at leastone of new/refill, refills remaining, pill count, gender, and age/dateof birth data contained in said prescription label printer file withcorresponding criteria in said CHR non-CID content table.
 16. The methodof claim 15 further comprising providing a central CS remote from saidlocal CS and said pharmacy store, said.
 17. A network computer system,comprising: (1) a central CS; (2) a plurality of local CSs ; whereinsaid central CS and said plurality of local CSs form a network in whichsaid plurality of local CS and said central CS can communicate with oneanother via network protocols; wherein each local CS of said pluralityof local CSs is associated with and proximate to a correspondingplurality of pharmacy stores, wherein each local CS of said plurality oflocal CSs includes a CS terminal for inputting information aboutpharmacy orders and a pharmacy printer for printing information relatingto said pharmacy orders; wherein each local CS of said plurality oflocal CSs is designed to log information about pharmacy orders includinginformation about medicines contained in pharmacy orders; wherein afirst local CS of said plurality of local CSs includes a first pharmacyprinter located in a first pharmacy store and a first pharmacy POSlocated in said first pharmacy store; wherein said first pharmacyprinter includes a first pharmacy printer database storing: (1) medicinerecords including in each medicine record a medicine identifier inassociation with information about the corresponding medicine; and (2)consumer records including in each consumer record a consumer identifierin association with CHR content to be conveyed to the consumerassociated with said consumer identifier; wherein said pharmacy printeris configured to receive and process print instructions resulting from apharmacy order containing a specified prescription for a specifiedmedicine having a specified medicine identifier and a specified consumeridentifier for a specified consumer, by: (1) searching in said firstpharmacy printer database for information about said specified medicineassociated with said specified medicine identifier; (2) searching insaid first pharmacy printer database for information to be conveyed tosaid specified consumer associated with said specified consumeridentifier; (3) printing in association with one another said specifiedprescription, said information about said specified medicine, and saidinformation to be conveyed to said specified consumer.
 18. The system ofclaim 17, wherein said CHR content is stored in said first pharmacyprinter database in association with said specified consumer identifier.19. The system of claim 17, wherein an identifier of said CHR content isstored in said first pharmacy printer database association with saidconsumer identifier.
 20. The system of claim 17 wherein said first localCS includes code instructing said first local CS to transmit to saidcentral CS information about pharmacy orders including associatedconsumer identifiers and an address associated with said first local CS.21. The system of claim 17 wherein said central CS includes code fordetermining from (1) criteria it-stores and (2) information aboutpharmacy orders associated with said specified consumer identification,CHR information to associate with said consumer identification, and saidcentral CS includes code for transmitting an identifier of said CHRinformation to said first local CS.
 22. The system of claim 17 whereinsaid central CS includes code for transmitting to said first local CSmedicine records including in each medicine record a medicine identifierin association with information about the corresponding medicine. 23.The system of claim 17 wherein said first local CS includes code forstoring in said first pharmacy printer database (1) medicine recordsincluding in each medicine record a medicine identifier in associationwith information about the corresponding medicine and (2) CHRinformation and an identifier of said CHR information.
 24. The system ofclaim 23 wherein said medicine records comprise medicine monograph dataand MedGuide data.
 25. The system of claim 17 wherein said CHR contentincludes at least one of (1) names of alternative brands of a medicinespecified in prescription contained in a corresponding pharmacy order,(2) an incentive offer for a subsequent purchase of a product other thansaid medicine, and (3) informational messages promoting said specifiedmedicine.
 26. The system of claim 17, wherein said central CS includescode for periodically transmitting identifiers of CHR information inassociation with said consumer identification to said first local CS.27. The system of claim 26, wherein said central CS includes code forautomatically transmitting identifiers of CHR information that it hasassociated with said consumer identification to said first local CS inresponse to transmission from said local CS to said central CS of saidconsumer identification, so that said CHR information is printed by saidfirst printer concurrently or sequentially with printing by said firstpharmacy printer of said specified prescription and information aboutsaid specified medicine.
 28. The system of claim 17, wherein said firstlocal CS is inside a local area network (LAN).
 29. The system of claim28, wherein said central CS is networked to each local CSs over a widearea network.
 30. The system of claim 29, wherein data transmissionspeed in said LAN is greater than the data transmission speed in saidWAN.
 31. The system of claim 27, wherein data storage size in said firstpharmacy printer database for said specified prescription, saidinformation about said specified medicine, and said information to beconveyed to said specified consumer exceeds ten megabytes.
 32. Thesystem of claim 27 wherein said first pharmacy printer database storelocal rules that the printer implements in addition to the rulesinstructing it to what to print based upon identifications of medicinesand CIDs, wherein said local rules include at least one of (1) contentlocal rules to print additional text or graphics upon receipt ofinstructions to print specified CHR content and CHR additional contentand the other print file information and (2) layout local rules to layout all of the material for printing defined by the print fileinformation and the specified CHR content and CHR additional content,depending upon all of the material for printing, the type of printer,and print specification such as paper width and margins.
 33. The systemof claim 17 wherein said central CS stores a master set of rules basedupon printer type, material for printing, and print specifications, andincludes code specifying that said central CS distributes correspondingrules to printers having corresponding printer type, material forprinting, or print specifications stored by said central CS.
 34. Thesystem of claim 17 wherein said system is designed to deliver to saidfirst pharmacy printer instructions in response to a pharmacy order forprinting information for the consumer placing said first pharmacy order,transmitted by both a first local CS controller CPU in the first localCS and also from said central CS.
 35. The system of claim 34 whereinsaid first pharmacy printer includes code to prioritize printinstructions received from both said first local CS controller CPU andthe central CS regarding a single pharmacy order.
 36. The system ofclaim 17 wherein said first local CS generates a de-identified pharmacyorder from said first pharmacy order, encrypts said consumeridentification associated with said first pharmacy order, and transmitsthe de-identified pharmacy order in association with the encryptedconsumer identification to said central CS.
 37. A method of using anetwork computer system, comprising: